Systemic reactive amyloidosis associated with Castleman's disease: serial changes of the concentrations of acute phase serum amyloid A and interleukin 6 in serum.
A case is reported of a 21 year old woman who suffered from Castleman's disease and systemic reactive amyloidosis. The serum concentrations of serum amyloid A (SAA) and interleukin 6 (IL-6) were extremely high and amyloid protein was immunohistochemically identified as AA. After surgical excision of a large retroperitoneal lymph node with the pathological findings of plasma cell type of Castleman's disease, both serum SAA and IL-6 declined, showing a similar pattern of reduction curves. All clinical symptoms and laboratory abnormalities greatly improved. The biochemical feature of Castleman's disease is abnormal production of IL-6 and this cytokine continuously may stimulate the synthesis of an amyloid precursor, SAA, causing systemic reactive (AA) amyloidosis. This pathogenetic theory is strongly supported by the present study.
Ikeda
S
S
Department of Medicine (Neurology), Shinshu University School of Medicine, Matsumoto, Japan. ikedasi@gipac.shinshu-u.ac.jp
Chisuwa
H
H
Kawasaki
S
S
Ozawa
J
J
Hoshii
Y
Y
Yokota
T
T
Aoi
T
T
D000328:Adult; D000686:Amyloidosis / Q000097:blood / Q000209:etiology*; D005871:Castleman Disease / Q000097:blood / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D000685:Serum Amyloid A Protein / Q000378:metabolism*
D015850:Interleukin-6; D000685:Serum Amyloid A Protein